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22 Widener L. Rev. 201 (2016)
Domestic Violence, Children, and Toxic Stress

handle is hein.journals/wlsj22 and id is 217 raw text is: DOMESTIC VIOLENCE, CHILDREN, AND TOXIC STRESS ALLAN R. DE JONG, M.D.' It is easier to build strong children than to repair broken men. Frederick Douglass The child is the father of the man. William Wordsworth 1. INTRODUCTION It is estimated that approximately 1.5 million women and 830,000 men experience physical or sexual assault annually in the United States by intimate partners, commonly called domestic violence.' In the United States, more than 15 million children live in families in which domestic violence occurs and almost half of these children witness severe violence in assaults of a parent.2 As individuals and as a society, we need to face the reality that exposure of children to domestic violence undermines healthy physical and emotional development for the child, which places the child at increased risk of physical and emotional diseases and disabilities as adults.' The effects of domestic violence on children include social consequences, physical consequences, and behavioral or neuroendocrine consequences that may result in transient, long-lasting or permanent harm to the child.' The purpose of this discussion is to provide a medical background for the urgency for appropriate intervention in situations where domestic violence occurs in the presence of children. II. OVERVIEW OF THE EFFECTS OF DOMESTIC VIOLENCE ON CHILDREN The social consequences for children include those related to the violence directed at their mother and the common association of domestic violence and child abuse. Studies indicate that families with either child abuse or * Dr. De Jong is the Medical Director of the Children at Risk Evaluation (CARE) Program at the Nemours - A. 1. duPont Hospital for Children in Wilmington, Delaware and Clinical Professor of Pediatrics at the Sidney Kimmel Medical College of Thomas Jefferson University. For more than 35 years, Dr. De Jong has conducted medical evaluations for suspected victims of child abuse. I Jonathan D. Thackeray et al., Clinical Report-Intimate Partner Violence: The Role ofthe Pediatrician, 125 PEDIATRICS 1094, 1094-95 (2010), http://pediatrics.aappublications.org/con tent/1 25/5/1094. 2 Megan Bair-Merritt et al., Silent Victims-An Epidemic of Childhood Exposure to Domestic Violence, 369 NEw ENG. MED. 1673, 1673 (2010), http://www.nejm.org/doi/full/10. 1056/NEJMpI307643. Thackeray, supra note 1, at 1095; Bair-Merritt, supra note 2, at 1674. 4 Thackeray, supra note 1, at 1095. 201

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